Depressive Symptoms and Gut Microbiota after Bowel Preparation and Colonoscopy: A Pre-Post Intervention Study.

Mechanical bowel preparation (MBP) is essential for visualisation of the colon during colonoscopy. Previous studies have identified changes in gut microbiota composition after MBP and colonoscopy. Considering the gut microbiota is increasingly implicated in psychiatry, we explored the potential impact of this intervention on mood and the microbiota-gut-brain axis.

Prior Appendicectomy and Gut Microbiota Re-Establishment in Adults after Bowel Preparation and Colonoscopy.

Emerging evidence suggests that the human vermiform appendix is not a vestigial organ but rather an immunological organ of biological relevance. It is hypothesised that the appendix acts as a bacterial 'safe house' for commensal gut bacteria and facilitates re-inoculation of the colon after disruption through the release of biofilms. To date, no studies have attempted to explore this potential mechanistic function of the appendix.

Process evaluation and early outcomes of real-world implementation of a pharmacist-driven cabotegravir/rilpivirine long-acting injectable initiative.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Developing a taxonomy of hazards and hazard mitigation strategies for Motorised mobility scooter users.

The increased use of motorised mobility scooters (MMSs) presents a road safety challenge as using a MMS has risks for the user, pedestrians, and other road users. In relation to enhancing MMS driving safety, much of the training and available literature focuses on training vehicular control. Equally important is the need to investigate higher-order cognitive skills involved in driving MMSs, particularly hazard perception.

Oral versus intravenous antibiotics in the treatment of uncomplicated colonic diverticulitis: results of a randomized non-inferiority control trial.

Background: Colonic diverticular disease is common and its incidence increases with age, with uncomplicated diverticulitis being the most common acute presentation (1). This typically results in inpatient admission, placing a significant burden on healthcare services (2). We aimed to determine the safety and effectiveness of using intravenous or oral antibiotics in the treatment of uncomplicated diverticulitis on 30-day unplanned admissions, c-reactive protein (CRP), White Cell Count (WCC), pain resolution, cessation of pain medication, return to normal nutrition, and return to normal bowel function.

Failure to Rescue in Major Abdominal Surgery: A Regional Australian Experience.

Background: Failure to rescue (FTR) is increasingly recognised as a measure of the quality care provided by a health service in recognising and responding to patient deterioration. We report the association between a patient's pre-operative status and FTR following major abdominal surgery.

Methods: A retrospective chart review was conducted on patients who underwent major abdominal surgery and who suffered Clavien-Dindo (CDC) III-V complications at the University Hospital Geelong between 2012 and 2019.

Acute burn care and outcomes at the Hospital Nacional Guido Valadares (HNGV), Timor-Leste: A 7-year retrospective study.

The purpose of this study was to describe the epidemiology of patients presenting with acute burns and undergoing admission at Hospital Nacional Guido Valadares (HNGV) in Dili, Timor-Leste in the period 2013 to 2019. HNGV is the only tertiary referral hospital in Timor-Leste. This was a retrospective study involving all acute burn patients admitted to the surgical wards of HNGV from 2013 to 2019.

Learning and teaching stage 4 clinical decision making: progression from novice to expert.

Background: This paper describes the development of learning from novice to expert in Stage 4: Clinical Decision Making (CDM) in surgery: Postoperative reflection and review. It also outlines some or the assessment and teaching approaches suitable to facilitate that transition in skill level.

Methods: This paper is drawn from a much broader study of learning and teaching CDM, that used qualitative methodology based on Constructivist and Grounded Theory.

Tertiary Survey in the Days of Modern Imaging: Assessing the Detection Rate of Clinically Significant Injuries on Tertiary Survey in a Level 2 Trauma Centre.

Aim: To determine the utility of tertiary survey (TS) in patients subjected to whole-body CT (WBCT) or selective CT (SCT) following trauma.

Methods: A retrospective analysis was performed on trauma patients admitted to a level 2 trauma centre following the introduction of a standardised TS form in 2017. The initial imaging protocol (WBCT versus selective CT versus x-ray), subsequently requested imaging, standardised injury data, and length of stay (LOS) were recorded.

Acceptability of a HIV self-testing program among people who use illicit drugs.

Background: People who use illicit drugs (PWUD) remain at significantly elevated risk for HIV infection and continue to have very low testing rates. HIV self-testing (HIVST) has been shown to be acceptable among many high-risk populations, but less is known about PWUD.

Methods: From May-June 2021, a HIVST program was implemented at a syringe services program (SSP) in Louisville, Kentucky.

How to isolate and manage a colo-atmospheric fistula in a wound requiring negative pressure dressing: a novel technique using a plastic syringe.

We describe the management of a colo-atmospheric fistula following extensive debridement for abdominal wall necrotising fasciitis. This was a novel technique performed with VAC dressing and a plastic syringe to isolate the fistula from the surround tissue.

A systematic review of gut microbiota composition in observational studies of major depressive disorder, bipolar disorder and schizophrenia.

The emerging understanding of gut microbiota as 'metabolic machinery' influencing many aspects of physiology has gained substantial attention in the field of psychiatry. This is largely due to the many overlapping pathophysiological mechanisms associated with both the potential functionality of the gut microbiota and the biological mechanisms thought to be underpinning mental disorders. In this systematic review, we synthesised the current literature investigating differences in gut microbiota composition in people with the major psychiatric disorders, major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SZ), compared to 'healthy' controls.

How does qualitative data collection modality affect disclosure of sensitive information and participant experience? Findings from a quasi-experimental study.

Focus groups (FGs) and individual interviews (IDIs) can be conducted in-person or in several different online contexts. We conducted a quasi-experimental study and assessed sharing of sensitive or dissenting information and participant comfort in FGs and IDIs across four modalities: (1) in-person, (2) online video-based, (3) online chat-based (synchronous), and (4) online email/message board-based (asynchronous). Participants were systematically assigned to one of the four modalities and randomized to one of 24 FGs or 48 IDIs ( = 171).

The influence of experience and expertise on how surgeons prepare to perform a procedure.

Background: There is a paucity of literature describing how surgeons (either novice or expert) mentally prepare to carry out a surgical procedure. This paper focuses on these processes, and is part of a larger piece of research based on the Royal Australasian College of Surgeons (RACS) Clinical Decision Making model.

Methods: Interviews were conducted over a 3-year period with registrars, trainees, fellows and consultants in the Department of Surgery at one large regional hospital in Victoria.

Mapping timely access to emergency and essential surgical services: The Malaysian experience.

Background: Surgical conditions form a significant proportion of the global burden of disease. Since the 2015 World Health Assembly resolution A68.15, there is recognition that the provision of essential surgical care is an integral part of universal access to health care.

How is surgery included in the Strategic Health Plans of the Pacific, Papua New Guinea and Timor-Leste?

Background: Papua New Guinea, Pacific Island nations, and Timor-Leste represent a range of island nations with populations ranging from a few thousand to 8 million. They perform on average about 25% of the Lancet Commission of Global Surgery's target 5000 per 100 000 population and their health workforce have significant deficits of trained surgeons and anaesthetists. This study was conducted to determine how the current national health plans of these nations have included surgery and anaesthesia.

Transanal mesorectal excision: early outcomes in Australia and New Zealand.

Background: Transanal total mesorectal excision (taTME) aims to overcome some of the technical challenges faced when operating on mid and low rectal cancers. Specimen quality has been confirmed previously, but recent concerns have been raised about oncological safety. This multicentre prospective study aimed to evaluate the safety of taTME among early adopters in Australia and New Zealand.

Clinical activity and outcomes during Geelong's general surgery response to the coronavirus disease 2019 pandemic.

Background: The response to the coronavirus disease 2019 pandemic has required conserving capacity and resources to avoid the health sector being overwhelmed. This paper describes Geelong's general surgical response, surgical activity, outcomes and the effect on surgical training.

Methods: Data collected from surgical audits; hospital databases and patient's medical records were used to compare the first 7 weeks of our new service delivery (30 March to 17 May 2020) to the corresponding 7 weeks in 2019 (1 April 2019 to 19 May 2019).